4,502 results match your criteria Adrenal Disease and Pregnancy


19-hydroxy Steroids in the Aromatase Reaction: Review on Expression and Potential Functions.

J Endocr Soc 2021 Jul 23;5(7):bvab050. Epub 2021 Mar 23.

Department of Molecular Genetics and Microbiology, Duke University, Durham, NC 27710, USA.

Scientific evidence related to the aromatase reaction in various biological processes spanning from mid-1960 to today is abundant; however, as our analytical sensitivity increases, a new look at the old chemical reaction is necessary. Here, we review an irreversible aromatase reaction from the substrate androstenedione. It proceeds in 3 consecutive steps. Read More

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Gender-role behaviour and gender identity in girls with classical congenital adrenal hyperplasia.

BMC Pediatr 2021 06 5;21(1):262. Epub 2021 Jun 5.

Department of Pediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Introduction: Girls with classical congenital adrenal hyperplasia (CAH) are exposed to excess fetal adrenal androgens in-utero, and often born with masculinised genitalia. They are conventionally reared as females, but show more "boyish" gender-role behaviour (GRB) and gender-identity (GI) issues in childhood and adolescence. Male-rearing is also reported mainly due to delayed treatment and/or socio-cultural factors. Read More

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Maternal Exposure to Adversity: Impact on the Microbiota-Gut-Brain Axis, Inflammation and Offspring Psychiatric Outcomes.

Mod Trends Psychiatry 2021 6;32:26-39. Epub 2021 May 6.

Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Psychosocial stress, driven by a variety of sources and influences, can be ubiquitous in our modern society. Prolonged exposure to these stressors can have detrimental biological and psychological effects; extant findings in childhood adversity indicate that the cumulative effects of exposure to childhood adversity increase risk for developmental delays, altered immune responses, and psychopathology later in life. The pathways by which these effects are conferred continue to be studied. Read More

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Maternal precarity and HPA axis functioning shape infant gut microbiota and HPA axis development in humans.

PLoS One 2021 20;16(5):e0251782. Epub 2021 May 20.

Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.

Background: Early life exposure to adverse environments, and maternal stress in particular, has been shown to increase risk for metabolic diseases and neurobehavioral disorders. While many studies have examined the hypothalamic-pituitary-adrenal axis (HPA axis) as the primary mechanism behind these relationships, emerging research on the brain-gut axis suggests that the microbiome may play a role. In this study, we tested the relationships among maternal precarity and HPA axis dysregulation during the peripartum period, infant gut microbiome composition, and infant HPA axis functioning. Read More

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Diagnosis and outpatient management of Gitelman syndrome from the first trimester of pregnancy.

BMJ Case Rep 2021 May 12;14(5). Epub 2021 May 12.

Emergency Admission Unit, Colchester General Hospital, Colchester, UK.

A 32-year-old woman presented with an incidental finding of hypokalaemia on routine bloods at 9 weeks of a second pregnancy, on a background of lifelong salt craving. Her previous pregnancy was uncomplicated. She had no previous significant medical or family history. Read More

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A 45-year-old female patient with Sheehan's syndrome presenting with imminent adrenal crisis: a case report.

J Med Case Rep 2021 May 8;15(1):229. Epub 2021 May 8.

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Background: Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis.

Case Presentation: We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Read More

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Pheochromocytoma and Paraganglioma in Pregnancy: a New Era.

Curr Cardiol Rep 2021 05 7;23(6):60. Epub 2021 May 7.

Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.

Purpose Of Review: Pheochromocytoma and paraganglioma (PPGL) in pregnancy is a rare entity and management of these patients is fraught with uncertainty. Our objective is to review current literature and discuss diagnosis and management of these patients.

Recent Findings: Outcomes of PPGL in pregnancy have improved in recent years. Read More

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A Case of Sheehan Syndrome 7 Years Postpartum with Transaminitis and Hyperlipidemia.

Am J Case Rep 2021 May 5;22:e930908. Epub 2021 May 5.

Internal Medicine, Mayo Clinic Health System - Southwest Minnesota region, Mankato, MN, USA.

BACKGROUND Sheehan syndrome (pituitary necrosis after postpartum hemorrhage) can present in various ways, depending on the hormones that are deficient. There may be a long delay to diagnosis of over a decade because symptoms are often vague and pituitary dysfunction progresses gradually. We describe a case of a patient with acute presentation of Sheehan syndrome 7 years after the obstetric event and with no clear precipitating event. Read More

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New genetic and clinical evidence associated with fetal Beckwith-Wiedemann syndrome.

Prenat Diagn 2021 Jun 11;41(7):823-827. Epub 2021 May 11.

Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University, Meaung, Chiang Mai, Thailand.

Early detection of Beckwith-Wiedemann syndrome (BWS) is very important since it is very useful regarding counseling of parents concerning the risk of developing embryonic tumors, selection of the mode of delivery due to potential adrenal cysts that might bleed during labor, prevention of neonatal hypoglycemia and even options of pregnancy termination in non-viable fetuses. This report describes the prenatal classic sonographic triad of fetal BWS (omphalocele, macrosomia, macroglossia) and other supporting findings (hepatomegaly, adrenal enlargement) as well as additional postnatal evidence. Also, it demonstrates new molecular genetic evidence potentially associated with the disease (the presence of a novel heterozygous c. Read More

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Sex Differences in the Exocrine Pancreas and Associated Diseases.

Cell Mol Gastroenterol Hepatol 2021 Apr 22. Epub 2021 Apr 22.

Center for Reproductive Sciences, Department of Obstetrics, Gynecology and the Reproductive Sciences, University of California, San Francisco, California. Electronic address:

Differences in pancreatic anatomy, size, and function exist in men and women. The anatomical differences could contribute to the increase in complications associated with pancreatic surgery in women. Although diagnostic criteria for pancreatitis are the same in men and women, major sex differences in etiology are reported. Read More

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Striae and an Adrenal Mass.

N Engl J Med 2021 Apr;384(16):e57

Mount Sinai Hospital, Toronto, ON, Canada

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Type 3 antenatal Bartter syndrome presenting with mild polyuria.

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Department of Pediatrics, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.

Bartter syndrome (BS) is a well-recognised inherited tubular dysfunction that causes polyuria, metabolic alkalosis and hypokalaemia. Among BS cases, antenatal/neonatal BS (ABS) usually shows distinct polyhydramnios prenatally and presents features of BS in the early neonatal period. We encountered a premature infant with type 3 ABS presenting with mild polyuria and discuss the pathogenesis of mild polyuria in type 3 ABS. Read More

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A Rare Cause of Refractory Severe Polyhydramnios: Antenatal Bartter Syndrome.

Medicina (Kaunas) 2021 Mar 16;57(3). Epub 2021 Mar 16.

Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul 07804, Korea.

: Antenatal Bartter syndrome is an autosomal recessive disorder causing severe polyuria that leads to severe polyhydramnios and preterm labor. Prenatal diagnosis of antenatal Bartter syndrome is difficult because the genetic diagnosis can only be confirmed following a clinical diagnosis in infants. Reports of prenatal diagnosis and treatment of antenatal Bartter syndrome are limited. Read More

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Impact of the coronavirus infectious disease (COVID-19) pandemic on the provision of inflammatory bowel disease (IBD) antenatal care and outcomes of pregnancies in women with IBD.

BMJ Open Gastroenterol 2021 03;8(1)

IBD Unit, Hull University Teaching Hospitals NHS Trust, Hull, UK.

Background: The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes. Read More

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Postpartum pheochromocytoma-induced takotsubo syndrome.

BMJ Case Rep 2021 Mar 19;14(3). Epub 2021 Mar 19.

Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan

A postpartum patient with acute-onset dyspnoea and hypotention, associated with reduced left ventricular function requiring intensive blood pressure control, was initially misdiagnosed as having peripartum cardiomyopathy. Her clinical symptoms rapidly resolved. Echocardiography revealed reversible left ventricular dysfunction with apical ballooning and coronary angiography was normal. Read More

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Effect of dexamethasone in patients with ARDS and COVID-19 - prospective, multi-centre, open-label, parallel-group, randomised controlled trial (REMED trial): A structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Mar 1;22(1):172. Epub 2021 Mar 1.

Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Gower Street, London, WC1E 6BT, UK.

Objectives: The primary objective of this study is to test the hypothesis that administration of dexamethasone 20 mg is superior to a 6 mg dose in adult patients with moderate or severe ARDS due to confirmed COVID-19. The secondary objective is to investigate the efficacy and safety of dexamethasone 20 mg versus dexamethasone 6 mg. The exploratory objective of this study is to assess long-term consequences on mortality and quality of life at 180 and 360 days. Read More

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[Clinical characteristics of 21 infertile women with non-classic 21-hydroxylase deficiency].

Zhonghua Fu Chan Ke Za Zhi 2021 Feb;56(2):108-113

Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China.

To investigate the clinical features of infertile women with non-classic 21-hydroxylase deficiency (21-OHD). The study enrolled 21 infertile women with non-classic 21-OHD in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2009 to December 2018. The clinical presentation, endocrine hormone, glucolipid metabolism and treatment outcome were retrospectively analyzed. Read More

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February 2021

Laparoscopic Bilateral Adrenalectomy in a Young Female Patient with Recurrent Cushing's Disease.

Case Rep Endocrinol 2021 12;2021:6632436. Epub 2021 Feb 12.

Department of Surgery, Teaching Hospital Peradeniya, Kandy, Sri Lanka.

Introduction: Synchronous bilateral adrenalectomy is undertaken less often due to numerous perioperative challenges and rare circumstances of patients needing this procedure. Bilateral adrenalectomy is an important second-line option for patients with persistent or recurrent hypercortisolism following transsphenoidal surgery for Cushing's disease. Here, we present a challenging case of synchronous laparoscopic bilateral adrenalectomy for a young female patient with recurrent Cushing's disease and fertility wishes. Read More

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February 2021

Expanded carrier screening using next-generation sequencing of 123 Hong Kong Chinese families: a pilot study.

Hong Kong Med J 2021 Feb 18. Epub 2021 Feb 18.

The Chinese University of Hong Kong-Baylor College of Medicine Joint Center of Medical Genetics, Hong Kong.

Introduction: To determine the carrier frequency and common mutations of Mendelian variants in Chinese couples using next-generation sequencing (NGS).

Methods: Preconception expanded carrier testing using NGS was offered to women who attended the subfertility clinic. The test was then offered to the partners of women who had positive screening results. Read More

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February 2021

Maternal psychiatric status and infant wheezing: The role of maternal hormones and cord blood cytokines.

Pediatr Pulmonol 2021 Jun 15;56(6):1573-1582. Epub 2021 Feb 15.

Department of Pediatric Allergy and Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey.

Rationale: Maternal psychosocial stress might be associated with development of allergic diseases in the offspring.

Objectives: To evaluate the association of maternal depression and anxiety with ever wheezing and recurrent wheezing among infants and to assess the role of maternal hypothalamo-pituatary-adrenal axis changes and fetal immune response in this association.

Methods: This study encompasses two designs; cohort design was developed to evaluate the association of prenatal depression with development of wheezing in infants while nested case-control design was used to assess the role of maternal cortisol and tetranectin and cord blood interleukin 13 and interferon γ. Read More

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Case Report: Late-Onset Congenital Adrenal Hyperplasia and Acute Covid-19 Infection in a Pregnant Woman: Multidisciplinary Management.

Front Endocrinol (Lausanne) 2020 15;11:602535. Epub 2021 Jan 15.

Endocrinology Unit, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Background: The impact of the Covid-19 infection on patients with chronic endocrine disease is not fully known. We describe here the first case of a pregnant woman with Covid-19 acute infection and non-classical congenital adrenal hyperplasia (NCAH).

Case Description: A woman at 36 weeks of gestation was referred to our Maternity Hospital for premature rupture of membranes (PROM). Read More

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February 2021

Impact of maternal prenatal stress by glucocorticoids on metabolic and cardiovascular outcomes in their offspring: A systematic scoping review.

PLoS One 2021 22;16(1):e0245386. Epub 2021 Jan 22.

Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Fulda, Germany.

Background: "Stress" is an emerging problem in our society, health care system as well as patient care, worldwide. Especially by focusing on pre-gestational, gestational but also lactation phases "stress" is to be considered as an own trans-generational risk factor which is associated with adverse metabolic as well cardiovascular outcomes in mothers and their children. Hence, the maternal hypothalamic-pituitary-adrenotrophic (HPA) axis may be stimulated by various "stress" mechanisms as well as risk factors leading to an adverse in utero environment, e. Read More

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Corticosteroids in the Management of Pregnant Patients With Coronavirus Disease (COVID-19).

Obstet Gynecol 2021 02;137(2):379-380

Obstetrics & Gynecology, Surrey Memorial Hospital, Fraser Health, Surrey, and Faculty of Medicine, Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.

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February 2021

Corticosteroids in the Management of Pregnant Patients With Coronavirus Disease (COVID-19).

Authors:
Todd Rosen

Obstet Gynecol 2021 02;137(2):378-379

Department of Obstetrics and Gynecology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

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February 2021

An exploratory study of perinatal hair cortisol concentrations in mother-infant dyads with severe psychiatric disorders versus healthy controls.

BJPsych Open 2021 Jan 7;7(1):e28. Epub 2021 Jan 7.

Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands.

Background: Maternal psychopathology during pregnancy is associated with negative outcomes in offspring. Increased placental transfer of maternal cortisol may contribute to mediate this association. Hair cortisol concentrations (HCCs) appear to be a good biomarker of long-term prenatal stress exposure. Read More

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January 2021

Diagnosing and managing adrenal crisis in pregnancy: A case report.

Case Rep Womens Health 2021 Jan 10;29:e00278. Epub 2020 Dec 10.

Walter Reed National Military Medical Center, Department of Obstetrics & Gynecology, United States of America.

Background: The diagnosis of adrenal insufficiency in pregnancy is relatively rare. Further, making this diagnosis can be challenging as many of the symptoms overlap with normal symptoms of pregnancy. Given the potential for severe maternal and fetal morbidity and mortality, early recognition and prompt comprehensive treatment are critical. Read More

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January 2021

Neurological manifestation in severe hypothyroidism in pregnancy.

BMJ Case Rep 2020 Dec 28;13(12). Epub 2020 Dec 28.

Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. Read More

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December 2020

[Dizygotic pregnancy as a possible mechanism of fetal gestation with a biallel mutation in the CYP11A1 gene: clinical case description].

Probl Endokrinol (Mosk) 2020 Sep 28;66(4):45-49. Epub 2020 Sep 28.

Endocrinology Research Centre.

One of the variants of congenital dysfunction of the adrenal cortex is a deficiency of the enzyme P450scc, which catalyzes the first stage of steroidogenesis. This is a rare autosomal recessive disease, the classic manifestation of which is primary adrenal insufficiency with a deficiency of gluco-and mineralocorticoids and a violation of the synthesis of sex steroids, which usually leads to a complete lack of masculinization in patients with karyotype 46, XY and hypergonadotropic hypogonadism in both sexes. Previously, it was suggested That p450scc deficiency is incompatible with the normal course of pregnancy, since the enzyme is expressed in the placenta, where it is necessary for the synthesis of progesterone, the main pregnancy hormone, and, consequently, the birth of a child with A p450scc deficiency is impossible. Read More

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September 2020

Prenatal inflammation enhances antenatal corticosteroid-induced fetal lung maturation.

JCI Insight 2020 12 17;5(24). Epub 2020 Dec 17.

Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Respiratory complicˆations are the major cause of morbidity and mortality among preterm infants, which is partially prevented by the administration of antenatal corticosteroids (ACS). Most very preterm infants are exposed to chorioamnionitis, but short- and long-term effects of ACS treatment in this setting are not well defined. In low-resource settings, ACS increased neonatal mortality by perhaps increasing infection. Read More

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December 2020